Learn to Develop an Audit Sustainable Claim
Reimbursement Services Group Inc. is the leading provider of Medicare Bad Debt claiming services. Through our training services, we provide the guidance your staff needs to ensure that every dollar that is claimable for Medicare bad debt is properly handled throughout the billing and collection cycle. Our goal is to help your staff properly identify Medicare bad debt balances, identify areas for improving your Medicare bad debt claim and avoid costly audit adjustments.
RSG Inc. will give your PFS staff a clear understanding of the procedures they should follow in order to maximize your Medicare bad debt claims, including the specific CMS requirements for the self pay, crossover and charity care components of the claim.
During a typical one-day training, RSG Inc. will:
- Summarize the Federal Medicare bad debt program as well as recent MAC rulings.
- Review of your hospital’s written bad debt, charity care and small balance write-off policies. RSG Inc. will clarify and interpret Medicare’s rules and regulations, and ensure that your policies and processes are compliant.
- Review hospital’s internal processing of all balances that flow into the Medicare bad debt claim, and identify areas that may violate Medicare’s rules.
- Review the process and documentation requirements for the hospital’s outside collection agencies.
- Establish a phone/email ‘hotline’ for your staff to use to contact us for ongoing post-training support.
Often the most vulnerable component of the claim, Medicare’s rules and regulations impact this source of Medicare bad debt the most. RSG Inc. will teach your staff how to avoid the most common pitfalls concerning your self-pay balances.
RSG Inc. will review your charity care policies, or help you develop those policies if needed. Charity care balances are often difficult to claim, and RSG Inc. will outline the steps necessary to ensure these balances withstand the scrutiny of future audits.
Depending upon your Medicaid State Plan, dual-eligible balances may qualify for inclusion in your Medicare bad debt claim. RSG Inc. will identify the opportunities for a crossover claim, and ensure that your staff is knowledgeable about the documentation requirements for this category of Medicare bad debt.
Outside Collection Agencies
Often, the ability to successfully claim self-pay balances is directly linked to your outside collection agencies. RSG Inc. will discuss the impact of outside collection agencies, how to ensure that your policies and procedures are being followed, and how to ensure that your self-pay balances are protected for inclusion in future Medicare bad debt claims.